Stop robbing my pharmacies, junkie motherfuckers!!!

The BBQ Pit
1

Just got a frantic text from a friend while I was at work today:

“We were just robbed, I think I’m going to pass out.”

For the umpteenth time in 3 months, another pharmacy in my area has been robbed by junkie scumbags looking for as much oxycodone they can lay their hands on. They’re jumping over counters, holding guns to people’s heads, and in one instance a couple years back, beating a 70 year old pharmacist with a crowbar.
I have known people who work in every store that’s been robbed in my district recently. These are stores I’ve worked at, places I’ve spent a lot of time in. These are my friends.

And I am sick and fucking tired of wondering when it’s my turn, wondering if every guy who walks up to the pharmacy with a funny look on his face is about to pull a gun on me. I’m tired of wondering if the piece of paper he’s sliding towards me says “Amoxicillin 500mg” or “Give me everything in the safe and nobody gets shot.” I’m tired of my pharmacists being afraid to work alone at night because they too know it’s just a matter of time, and they don’t want to be alone when it happens.

Walgreens experienced so many robberies that they stopped carrying all forms of oxycodone in their regular stores. Now they have one store in each district that will stock it, with a 24/7 armed guard in the store. One guy I know put up a sign when he was working overnights alone that said he didn’t keep it in stock. Didn’t stop the guy who put a gun to his head, and it made us all sick to watch the video of him pleading for his life for well over 10 minutes, wondering if this psycho was going to blow his brains out. The guy eventually found some in the bins and left with it.

But it’s not just overnighters that have cause to be concerned now. In June, a Sweetbay in my county was robbed at 11:30 in the morning. The one that got hit today was 1pm with 2 female techs and one pharmacist while patients were sitting in the waiting area.

I mean, what the fuck?

2

It’s definetely an issue, especially since Oxycontin is so addictive and expensive. I wonder if there are equally effective painkillers that aren’t so damn sought after or narcotic.

3

Yeah - that truly sucks.

It hits a little close for me - my cousin is going through hell right now because his wife got strung out on the stuff working as a nurse. She lost her nursing license, almost landed in the clink for stealing tons of oxy from the hospital, had to go through rehab, and now their marriage is pretty much over. He’s wringing his hands because he knows his kids have to come first in whatever happens next, and he’s a bit at a loss on how to help them.

Awful stuff.

4

Yeah, I’ve thought that perhaps somebody needs to do some sort of societal cost/benefit analysis on that stuff. It sure seems like a whole bunch more people are fucked up because of it rather than not fucked up because of it. Of course, people in real pain shouldn’t have to suffer because of a bunch of addicts, either.

5

Living with pain is no joke. And with really bad pain and an end-of-life issue, addiction becomes something health care workers typically don’t worry about quite as much.

The real sticking point is with terrible acute pain, or a long-term painful chronic condition that resolves in time. These present the real challenges in pain management. Winding up with an addiction this way is just a real mess all around - and adds a huge complication to the lives of people just trying to get healthy again.

And then there are the dickheads who never are in pain and just grab hold of these drugs for kicks. That’s hard to defend.

6

Methadone is a fantastic pain-killer, with few of the “high” benefits one typically gets from other opioid narcotics. It’s a naturally long-acting drug, so you can’t circumvent a long-acting tablet release mechanism like you can with other CR opiates (Oxycontin, Avinza, Kadian, fentanyl lozenges). Unfortunately, it’s notoriously difficult to properly dose and has other issues and stigma attached to it which prevent most physicians from using it (even though, compared to oxycontin, it’s dirt cheap since it has been generic for years now).

The previous pharmacy I worked in was robbed on Memorial Day, while I was there. What did the guy want? Oxycontin. Fortunately, he believed us when we said we had none (we really didn’t) and demanded something else instead, which we gave him and he bolted.

It’s sad, really, since many people do benefit from these medications.

7

It’s the first narcotic I tend to prescribe when a long-acting opiate is indicated.

But it does take a lot of practice to figure out the dosing, and ya gotta make sure their kidneys and livers are in good enough shape, or dosing it will get even tougher.

There are no easy answers to the problem of chronic, non-malignant pain. Narcotics are one tool in myoolbox, but not the first one I reach for. And for patients with a significant addiction history, they probably should not be reached for.

There’s very little actual need for a drug like oxycontin. It’s widespread use is due more to marketing than to unique benefit over other available meds.

8

And then when you or someone in your household does have a legal script for it, or a similar drug, it can be damn hard to find a pharmacy that can fill it.

9

I asked my doctor about that, wondering why, 100 years more or less after they started controlling narcotics, they haven’t been able to come up with non-narcotic substitutes that are equally effective against pain. He told me that the way brain processes pain and pain relief is so tightly bound to the way addiction works that such a breakthrough was unlikely even in the long term.

10

“Addicts” and “people in real pain” are not necessarily disjoint sets. It’s more than possible to become hooked through therapeutic use, after which you can hopefully be titrated down.

11

If I rember right you are a doctor in a prison. I would expect narcotics would be really fun to persribe just for logistic issues.

12

Isn’t part of the problem with these narcotic painkillers that the person that is given a legitimate scrip for a legitimate pain issue becomes dependent on the drug in such a way that the body “tricks” the mind into believing that the pain still exists, even when it doesn’t anymore, thereby continuing to feed the addiction because the patient is still reporting pain to the doctor?

13

A local suburb just shut down a ‘methadone clinic,’ even though they only take patients with private insurance programs (intended to mean to the suburbanites: no junkies on public assistance) and do provide to patients with legitimate pain issues. The locals didn’t think that was appropriate for their community, regardless. :rolleyes:

<semi-hijack> On the topic of Oxycontin, I know I’ve told this story here before but I’ll do it again. I’m on a research review board (IRB for those who know the terminology) for the medical center I work at. We review research involving human subjects being done at our institution. One study a few years back wanted to research Oxycontin versus some other pain treatment for arthritic knees or something like that. Anyway, the issue was that the subjects would be given a plain-looking pill to take daily for weeks; neither they nor the doctor would know which drug it was because the sponsoring company would send code-numbered bottles of meds that all looked like each other. At the end of the study - they would stop taking them. Cold turkey.

I was one of the people on the panel who objected strenuously. We sent the study back telling them the sponsor needed to create “tapering” doses of the drugs being used and wean them off the drug. The response we got was that they didn’t think it was needed, and their means of following up was a phone call 3 days after dose stoppage, and they’d deal with it then if needed.

One of our members worked in anesthesiology, and he was the most knowledgeable and vocal on the subject. His rant was a thing of beauty and sadly I would do no justice if I tried to remember it and reproduce it here. We found it cruel that they would go ahead and put subjects through withdrawal just because they didn’t want to be bothered with tapering them off the meds slowly. We sent the study proposal back with our commentary. I don’t recall it coming back to us again, but I wasn’t going to every meeting at that time.</hijack>

14

It’s not quite so clear-cut.

Gross oversimplification follows:

Narcotics work pretty good on acute pain, and relieve it well, with minimal risk of dependency. Any resultant physical addiction is pretty easily treated with a taper.

And inadequately treated severe acute pain often results in nerve remodeling changes, which can cause long-term chronic pain. So it’s important to treat moderately severe acute pain, with narcotics if necessary.

But often for chronic non-malignant pain, the med works at first, but eventually the effect diminishes, the patient requires more narcotics to get the same level of relief, etc etc until the patient is on enough morphine to kill an elephant, is constipated to hell and back, us tremendously physically addicted (and maybe psychologically too) and still has the same pain he started with.

Plus, for certain susceptible individuals, narcotics not only relieve physical pain, but the resultant euphoria reduces mental, emotional, spiritual pain too. And when the narcotic wears off, they want relief from those pains too! And the patient tends to not recognize the nature of these non-physical pains, but somatizes them into physical complaints.

Plus a lot of other stuff and factors, etc. :wink:

It’s complicated. That’s why I went thru training until I completed the 21st grade, and still do continuing education, including on how to treat pain. And I’m still learning slowly in this area.

15

I don’t know how it is for him, but at the local jails, every pill has to be accounted for, while every inmate receives his invidually, and supposedly signs for it, and the whole system is a huge mess.

16

Sounds like a “methadone maintenance clinic”. These places usually treat opiate addiction (heroin, oxycontin, etc) with high doses of methadone, not to treat pain, but to maintain their addiction with a less problematic drug. They’re becoming more and more targeted to the well-heeled addict rather than the down and out skid-row junkie. :rolleyes: Methadone maintenance has its role, but I’m not a big proponent of it. It’s interesting to hear they’re treating pain too.

Any doctor with a DEA number for Sched II can prescribe methadone for pain. But it takes special licensing and certification to be able to prescribe methadone for an addiction.

17

Sounds like our system in prison too!

18

ditto correction center, even circa 1990 and before.

19

Article here - Berwyn’s aldermen voted to allow the clinic, residents turned out to protest, all of the aldermen roll over and revoke their decision. The article mentions that the clinic has a branch in Evanston, which is a fairly upscale suburb in most places. Also, the owner of the other clinic and of the planned one is a resident of Berwyn, so one would think she has a vested interest in keeping her community nice.

This article isn’t clear but other news reports did make it sound like it wasn’t entirely for addicts, but I could be wrong.

20

I can’t say I’d want a methadone clinic in my own neighborhood, but I’m glad that one exists not too far from me. It’s not for everyone, that’s for sure, but it does seem to work well for me. I haven’t abused opiates since I began MMT. You trade an addiction for a dependence, and personally, I find it much easier and healthful to be on a controlled amount of methadone than out on the street paying tons of money for drugs and taking as much as I want (not safe and a great way to OD).

It’s not exactly a fun place to go though. The motives for being there are not all good ones, unfortunately. As far as I know, our clinic does not treat pain and they take many steps not to overmedicate. You have to go through paperwork and doctor’s orders to be stepped up even a little bit. And again, IMO, it’s better to be a little overmedicated on a drug that you are being supervised on than to be out on the street taking whatever you want. In no way is it a perfect system, but for a lot of us, it is a hell of a lot better than the alternative.

And the nifty thing about methadone is its ability to block other opiates once you are at a therapeutic dose. It’s pretty hard to abuse opiates once you are on MMT, at least for me. And I know I never would have stopped otherwise. YMMV